Review of High-Dollar Payments for Louisiana Medicare Part B Claims Processed by Pinnacle Business Solutions, Inc., for the Period January 1, 2003, Through December 31, 2003

The objective of this review was to determine whether Pinnacle Business Solutions, Inc.'s (Pinnacle) high-dollar Medicare payments to Louisiana Part B providers were appropriate.  Twenty-nine of the thirty high-dollar payments that Pinnacle made to providers were appropriate.  However, Pinnacle overpaid one provider $19,641 for the remaining payment.  We recommended that Pinnacle recover the $19,641 overpayment and consider using the results of this audit in its provider education activities.  Pinnacle agreed with the finding and recommendations.